Search

Background: Ocular trauma is complex and varied, and some occult intraocular foreign bodies (IOFBs) can lead to uncommon symptoms and signs. We report a case of rhegmatogenous retinal detachment (no obvious wound, no pain, no intraocular infection or other symptoms) caused by an occult intraocular aluminium foreign body, which could have been easily missed., Case Presentation: A 42-year-old male presented to the outpatient department of our hospital complaining of fluttering black dots and decreased vision in his left eye that began 3 months earlier. He was diagnosed with "floaters" at a community hospital. He denied a history of ocular trauma or previous surgery. The cornea and lens of the left eye were clear. A small patch of pigmentation was noted in the temporal sclera. Fundoscopy revealed macula-off retinal detachment. After mydriasis, elliptical holes were seen in the peripheral retina at 2:30, and a suspicious hyperreflective strip was found under the anterior lip of the retina by Goldmann three-mirror contact lens examination; the strip was confirmed to be an IOFB by orbital CT. The IOFB was removed through pars plana vitrectomy without any complications., Conclusion: Unlike iron and copper IOFBs, aluminium IOFBs are more inert and more likely to be missed. For people with special occupations (construction workers, mechanics, etc.), when abnormal pigmentation of the sclera is found, the possibility of foreign bodies in the eye should be considered. In the process of disease diagnosis and treatment, it is necessary to ask for a detailed history, including occupation history and practice, and perform careful physical and targeted examinations. Such comprehensive analysis regarding the above information will minimize the chance of missed diagnosis.Awareness of occult IOFB in high risk occupations and prompt referral to a retinal surgeon is of outmost importance., (© 2023. The Author(s).)

Purpose: To describe the demographics, clinical profile, and outcomes of ocular siderosis in patients presenting to a multi-tier ophthalmology hospital network in India., Methods: This cross-sectional and hospital-based study included 3,082,727 new patients who presented between August 2010 and December 2021. Patients with a clinical diagnosis of ocular siderosis in at least one eye were included., Results: Overall, 58 eyes of 57 patients (0.002%) were diagnosed with ocular siderosis. The majority were men (96.49%) and had unilateral (98.25%) affliction. The most common age group at presentation was during the third decade of life with 24 patients (42.11%). A clear history of ocular trauma was documented in 47 patients (81.03%). Major clinical signs included corneal pigment deposition in nearly half of the eyes (27/58 eyes, 46.55%), corneal scar (20/58 eyes, 34.48%), cataract (22/58 eyes, 37.93%) and retinal detachment (11/58 eyes, 18.96%). The intraocular foreign body (IOFB) was anatomically localized in a majority of the eyes (i.e., 45/58 eyes, 77.59%). The most common location of the IOFB was in the posterior segment (22/58 eyes, 37.93%). The eyes that underwent a vitreoretinal surgery with removal of IOFB had a slightly better BCVA (1.0 ± 1.01) when compared to eyes with non-removal of IOFB (1.58 ± 1.00)., Conclusion: Ocular siderosis is a rare sight-threatening entity, with half of the affected eyes exhibiting severe visual impairment. Majority of the eyes in ocular siderosis will have a detectable IOFB. Surgical removal of IOFB may lead to a better visual gain when compared to non-removal., Competing Interests: None

A patient complained of vision loss of his left eye which was crushed by iron ore for 11 months. The cornea of the injured eye was thin and swollen, and a large amount of rust-like material was observed to be deposited. An intraocular foreign body was found by orbital CT. During vitrectomy, a piece of metal sheet was found near the ora serrate, and the intraocular structure was severely damaged, and characterized by vitreous brown turbidity, a white optic disc, occlusion of blood vessels in the fundus, and peripheral retinal atrophy with degeneration. The patient was diagnosed as ocular siderosis in the left eye.

BACKGROUND Ocular siderosis is an uncommon cause of vision loss due to a retained ferrous intraocular foreign bodies (IOFB) that cause iron deposition in ocular tissues. The most common manifestations are cataract formation, diffuse pigmentary changes of the retinal pigment epithelium, iris heterochromia, dilated pupils, secondary glaucoma, iritis, and cystoid macular edema. CASE REPORT We report a case of 38-year-old man who presented with a left dilated pupil and visual field defect. Neurological examination results were normal. Brain magnetic resonance imaging revealed a gross artifact at the site of the left globe. The visual field test showed a peripheral arcuate nasal visual field defect in the left eye. Ophthalmic examination revealed peripheral pigmentary changes and a black elongated and elevated lesion located very anterior and inferior-temporal and attached to the retina with fibrous tissue. A computed tomography scan revealed a 1×1-mm-round hyperdense IOFB in the left vitreous cavity. The diagnosis of siderosis bulbi secondary to a missed IOFB was established. The patient underwent a pars plana vitrectomy for removal of the IOFB. Two weeks later, rhegmatogenous retinal detachment developed, and repair with silicon oil injection was done. One year after the last operation, the best corrected visual acuity in the left eye was 6/120, with normal intraocular pressure and an attached posterior pole. CONCLUSIONS This case highlights the importance of investigating for a retained IOFB in cases of unilateral retinitis pigmentosa changes.

Purpose: To describe the retention of large, tubular, nondissolving foreign bodies because of a complication of the intravitreal dexamethasone implant (Ozurdex)., Methods: This is a single-center, retrospective chart review of patients who were found to have retained, nondissolvable tubular foreign bodies in the vitreous cavity for more than 6 months (the expected dissolution time of the implants) after Ozurdex injections. Ocular symptomatology and multimodal imaging were reviewed., Results: Five patients had retained, nondissolvable tubular foreign bodies in the vitreous that persisted for months (mean 28.2 months, range 9-67 months) after intravitreal injection of Ozurdex. Two patients were symptomatic due to the foreign bodies and chose alternate local therapy, but none of the patients opted for surgical explantation., Conclusion: Persistent, nondissolving, tubular foreign bodies can be seen in the vitreous cavity for years after injection of the Ozurdex implant. Clinicians should be aware of this complication that has the potential to cause visual symptoms and ocular morbidity.

Purpose: To describe persistent remnants of dexamethasone intravitreal implant (DEX implant) and evaluate the risk factors for remnant persistence in patients who received a DEX implant., Methods: This retrospective observational study involved a retrospective chart review of 133 eyes from 129 patients who received DEX implant injection., Results: Seventeen eyes of 17 patients (12.78%) exhibited remnant persistence >1 year after DEX implant injection; eight eyes (13.33%) were diagnosed with branching retinal vein occlusion, three eyes (14.28%) were diagnosed with central retinal vein occlusion, and six eyes (35.3%) were diagnosed with diabetic macular edema. The number of intravitreal DEX implant injections and triamcinolone acetonide injections administered to eyes with remnant persistence was significantly higher than that administered to the eyes without remnant persistence (P < 0.001 and P = 0.024, respectively). Remnants caused symptomatic floaters in 11.7% (2/17 eyes) of the patients with remnants and in 1.5% (2/133) of the entire patient cohort., Conclusion: DEX implant was not completely dissolved in the eyes that received multiple DEX implant or triamcinolone acetonide injections.

Detailed evidence for psychogenic effects after an accident: evidence from 3 expert reports., Competing Interests: Nein., (Georg Thieme Verlag KG Stuttgart · New York.)

Introduction: Ocular siderosis is a rare but severe complication of open globe trauma with intraocular retention of a metallic foreign body., Case Study: We report a case of recurrent uveitis in a 37-year-old patient. The ophthalmic examination revealed poor vision in the left eye, lid edema, limbal scleromalacia, hyphema and severe ocular hypertension. Orbital CT showed the presence of a radio-opaque IOFB between the crystalline lens and vitreous body. An aqueous humor sample was obtained for iron and ferritin levels. The results came back 100 and 2000 times higher, respectively, than the serum reference values., Discussion: The very high iron content is the result of a sustained release from the metallic INFB and is responsible for ocular siderosis in our patient. The extremely high ferritin level would be the result of in situ synthesis by the various cells of the ocular structures in order to preserve the components of the eye. Measurement of these two levels would improve the diagnosis, prognosis and treatment of metallic IOFBs., (Copyright © 2017 Elsevier Masson SAS. All rights reserved.)

Aim: This study aimed to determine the causes of red eye disease among patients of Mazandaran-Northern Iran., Methods: This cross sectional study included 840 patients who referred to eye clinics with ocular complaints. A detailed history of patients was recorded and their eyes were examined. Then, pre designed checklists were completed by the researcher., Results: The most common cause of red eye was conjunctivitis - 30% (252/ 840), foreign bodies 23.2%, trauma including penetrating or blunt 8.6%, respectively. There was a significant relationship between the red eye trauma, with acute onset and duration of less than a week (P=<0.0001). Diagnoses of red eye were conjunctivitis in 31.3% of the cases separately, viral causes (19.5%), allergic (7%) and bacterial (4%), foreign bodies 22.9%, pterygium 7%, and trauma 6.5%, respectively., Conclusion: In the current study, the most common causes of red eyes were conjunctivitis, foreign bodies, and trauma respectively. Red eye was more common in males than in females. An appropriate and proper training of risky factors of red eyes in the future could reduce the risk of serious visual problems.

The red eye is a frequent symptom in emergency consultation. The general practitioner should be aware about the sample of possible etiologies. The diseases causing redness are various, sometimes benign but sometimes threatening vision. The most frequent diagnostic hypotheses will be summarized here, as well as the practical methodological elements allowing gross differential diagnosis in the absence of specific instrumentation.

Objective: In pediatric primary care, an adjunct for ophthalmology diagnosis and monitoring of treatment could be of great advantage. The portable polarized dermatoscope can readily fit the purpose as an alternative to the classic slit lamp device., Methods: We describe and demonstrate our clinical experience using the dermatoscope for diverse ocular conditions., Main Message: Beyond its effective primary role as an examination tool for detecting dermatopathology, the dermatoscope proves its worth in a variety of separate ophthalmologic clinical states where intricate details need recognition. From corneal or subtarsal foreign body identification, to tear gutter assessment, this instrument can facilitate our work whenever magnification and illumination is beneficial., Conclusion: The technique described raises the option of using a substitute for usually lacking, cumbersome equipment for many therapeutic situations, rural clinics and home visits, easily available for the busy pediatrician, demanding little training, and at a reasonable cost.

We show a clinical case of siderosis bulbi with absolute secondary glaucoma. The initial diagnosis was primary open angle glaucoma in both eyes, and the patient was treated with eye drops for 4 years. After reassessment of anamnesis, clinical and paraclinical investigations we find that one eye is normal and the real diagnosis in the involved eye.

The Uveitis Masquerade Syndromes (UMS) are a group of ocular diseases that mimic chronic intraocular inflammation. Many non-malignant conditions may result in an appearance mimicking an uveitis. The authors review most common non-malignant conditions which may be considered masquerades such as: retained intraocular foreign body, rhegmatogenous retinal detachment, myopic degeneration, pigment dispersion syndrome, ocular ischemic syndrome, infectious intraocular inflammation, retinitis pigmentosa, multiple sclerosis and drug and post-vaccination reactions.

A red eye is a cardinal sign of ocular inflammation. Most cases are benign and can be managed by the primary care provider. The key is recognizing cases requiring ophthalmological consultation by differentiating between ciliary and conjunctival injection. Ciliary injection indicates inflammation of the cornea, iris, or ciliary body, whereas conjunctival injection mainly affects the posterior conjunctival blood vessels.

Background: Siderosis bulbi (SB) is caused by un-removed intraocular iron-containing foreign bodies. Our retrospective study was designed to establish the number of patients treated for SB at our ophthalmology department within the past 10 years, and to find out why SB occurred., Patients and Methods: Retrospectively, we analyzed the documentation of every patient treated at our department for ocular injury due to an intraocular metal foreign body between 1.1.1992 and 1.1.2002. Particular attention was focussed on the documentation of patients exhibiting symptoms of SB., Results: During this period of time, 48 eyes with an intraocular iron-containing foreign body were treated operatively. In 45 cases, the foreign body was removed within 3 days after injury without any symptoms of SB. Of these, three patients (6.2%) came so late for treatment that various clinical signs of SB were already present., Conclusions: There are three major reasons for the development of SB: some patients do not come for an examination because there is no discomfort, the second reason is that the medical treatment at the first visit was too superficial and thirdly a small foreign body may also be overlooked due to deficient or inappropriate methods of examination. Therefore, sporadic cases of SB are still to be expected in the future.

Ophthalmomyiasis interna infestation by fly larva can present in various forms. A 3-year-old girl with a 15-day history of pain, redness, and tearing of the right eye was referred to our clinic with the diagnosis of endophthalmitis associated with an intraocular foreign body, based on clinical and ultrasonographic findings. The patient underwent pars plana vitrectomy, during which an 8-mm long larva was encountered within the vitreous cavity. It was removed and identified as a cattle botfly. The patient developed a retinal detachment 1 month postoperatively, but the family refused further treatment and the patient was lost to follow-up. Ophthalmomyiasis should be included in the differential diagnosis of endophthalmitis and intraocular foreign bodies in patients from rural areas.

The use of CT and MR imaging has improved the understanding of many congenital and acquired conditions in pediatric ophthalmology, resulting in more appropriate therapeutic intervention and giving insight into the pathogenesis of these conditions.

Purpose: To report a case of caterpillar setae embedded in the corneal stroma and inferotemporal retina with minimal inflammation., Design: Observational case report., Methods: A 4-year-old boy developed a red eye after playing with a caterpillar. He was placed on topical tobramycin/dexamethasone and referred for evaluation of embedded setae in his conjunctiva, cornea, iris, and retina. Examination revealed no iridocyclitis or vitritis., Results: Because of the lack of intraocular inflammatory response, no invasive intervention was conducted to remove or destroy the setae and he was tapered off the tobramycin/dexamethasone. At 4-month follow-up he remained asymptomatic with the setae still present in both his cornea and retina. In addition, vitreous membranes had formed in the immediate vicinity of the intraretinal setae., Conclusion: Intraretinal and corneal setae can be embedded with minimal inflammation and can be tolerated without need for surgical intervention.

Background: Microendoscope techniques got a more important role in intraocular diagnostic and therapy. The used optical systems are fiberbundle-endoscopes and gradient-index (GRIN)-endoscopes. This study is concerned with the possibilities and limits of GRIN-endoscopes in pig eye models and in clinical use., Patients and Methods: Several simulated intraocular techniques (phacoemulsification, implantation of intraocular lenses, vitrektomie, extraction of lost lens parts out of the corpus vitreous, extraction of metal foreign bodies) were done on pig eyes under GRIN-endoscopic control (GRIN-endoscope with diameter of 0.89 mm, Volpi, Switzerland). 3 clinical patients with cornea or lens opacities were examined., Results: The image quality of simulated operations on pig eyes in clear intraocular conditions with a GRIN-endoscope was good. Also the clinical intraocular examinations could be done well, although the additional information were different. The in vivo examinations gave in one case no information (vitreous opacities very tight), in one case a relative information (mild vitreous opacities) and in one case an additional information (vitreous opacities rare)., Conclusions: GRIN-endoscopes could complement the intraocular endoscopic spectrum in selected cases. At clear intraocular conditions good pictures were possible. GRIN-endoscopes could be used in cases where endoillumination is necessary. Then additional visual informations to the illumination are possible. The possibility to get overview images is limited with the actual endoscope probes. Ultrasound examination should be done in all cases with opacities of the anterior parts of the eye to get informations about the conditions inside the eye. Working inside the eye is possible with experience in this technique although a GRIN-endoscope has no stereopsis. Future developments should be done in stereopsis, several endoscope-tips and better handling (footpedal-controlling, autofocus).

Purpose: To assist clinicians in the diagnosis and management of ocular siderosis., Methods: The diagnosis and management of three cases of ocular siderosis secondary to a retained iron-containing intraocular foreign body are described., Results: Noteworthy features included: 1) the characteristic features of a tonic or Adies pupil (one case) and 2) the failure of high-resolution computed tomography scanning and plain film radiography to detect the intraocular foreign body (two of three cases). In contrast, ultrasonography demonstrated the intraocular foreign bodies in all cases and accurately localized them to the inferior retinal quadrants. A third noteworthy finding was that a preoperative electroretinogram reduction in amplitudes of as much as 40% compared with that of the uninvolved eye was compatible with excellent vision, and that the electroretinogram returned to normal after the intraocular foreign body was removed., Conclusions: Ocular siderosis should be considered in the differential diagnosis of a tonic or Adies pupil. To detect an occult intraocular foreign body, clinicians should not rely exclusively on computed tomography scanning or plain film radiography, but should also use B-mode echography with careful study of the inferior quadrants. In ocular siderosis a preoperative electroretinogram reduction in amplitudes of as much as 40% may be reversible after intraocular foreign body removal.

Primary care physicians have an important role in diagnosing and treating eye disorders--including dacryocystitis, blepharitis, and conjunctivitis--and in determining when ophthalmologic referral is needed. Fundus examination for diagnosis of glaucoma and diabetic eye complications should be a part of the routine examination in all adults. Patients with HIV or AIDS should be carefully monitored for cytomegalovirus retinitis. Children should be tested for amblyopia. Orbital cellulitis can have serious complications and must be vigorously treated. Finally, careful use of ophthalmologic topical agents, especially corticosteroid drops, is essential.

Step-by-step instructions for the most common and difficult ophthalmologic procedures that are performed in an emergency department. Foreign body removal, including rust rings, is explained with an emphasis on limiting further injury to the corneal epithelium and stroma. Patching, irrigation, contact lens removal and corneal culture techniques are explained. Three methods of assessing intraocular pressure are described.

The histopathologic and cytopathologic study of ocular fluids obtained for diagnostic purposes is presented. The analysis of fluid specimens with millipore filter, celloidin bag-cell block, and transmission electron microscopy techniques has proved to be effective for establishing and confirming clinical diagnoses. Diagnostic vitrectomy can be readily used to evaluate such conditions as intraocular tumors, lens and blood-induced glaucoma, inflammatory conditions, amyloidosis, persistent hyperplastic primary vitreous (PHPV), epithelial ingrowth, and tractional vitreoretinal membranes.

Computerized tomography does not give as fine an information as echography in the presence of intraocular changes, such as retinal detachments, organized vitreous hemorrhages or the differentiation of a choroidal prominence. Complementary computerized tomography, however, can be helpful in the presence of unclear echographic results in opaque media. Furthermore, an analysis of the value of computerized tomography and echography for the evaluation of orbital lesions is presented based mainly on the results of the preoperative tissue diagnosis in 31 histological proven lesions. The results show that a complementary CT-scan is not necessary in orbital lesions of the anterior third when a clear echographic tissue diagnosis exists. In lesions of the middle third of the orbit, echography and CT complement each other. For lesions situated within the orbital apex or for those which are in connection with adjacent structures, such as the intracranial space or the periorbital region, computerized tomography is superior and of a greater help than standardized A-scan echography aided by contact B-scan.

In eyes with opaque media, ophthalmic ultrasound provides a unique source of information that can dramatically affect the course of patient management. In addition, when an ocular abnormality can be visualized, ultrasonography provides information that supplements and complements other diagnostic testing. It provides documentation and differentiation of abnormal states, such as vitreous hemorrhage and intraocular tumor, as well as differentiation of orbital tumors from inflammatory causes of exophthalmos. Additional capabilities of ultrasound are biometric determinations for calculation of intraocular lens implant powers and drug-effectiveness studies. Maximal information is derived from ultrasonography when A-scan and B-scan techniques are employed simultaneously. Flexibility of electronics, variable-frequency transducers, and the use of several different manual scanning patterns aid in detection and interpretation of results. The immersion system of ultrasonography provides these features optimally.

The principles of diagnostic ultrasound and computed X-ray tomography are briefly described. The informations to be expected can be derived. First, the clinical use in determination of size and localization of the bulbus is discussed. This proved helpful in follow-up studies of buphthalmos, localization of intraocular foreign bodies and differentiation of pseudo-protrusion and protrusion (ultrasound exophthalmometry). The differentiation and localization of intraocular disorders (e.g. retinal detachment, intraocular tumors, vitreous hemorrhages, aqueous cysts) is facilitated. In space-occupying orbital disorders both methods complement but cannot replace each other. Therefore it appears that further development of ultrasonic diagnostic techniques should be promoted to reach at least the standards which are nowadays already achieved in computed X-ray tomography.

Echography is a valuable aid to the recognition differentiation and localization of various pathologic conditions of the eye and the orbit. The A and B scans should be used in combination. Since they complement one another to a considerable extent.

The application of ultrasonics has been one of the major developments in ophthalmology in the last two decades. Diagnostic ultrasound of the eye and orbit, together with ocular biometry (especially in the field of lens implantation), are now routine investigations, while ultrasonic surgery of the lens (phacoemulsification) has become a well-established part of our surgical armamentarium. The historical development of diagnostic ultrasound is reviewed, its physical basis is recalled, present-day techniques and instrumentation are outlined, and future possibilities considered.

Ultrasound examination has emerged as a valuable technique for defining soft tissue abnormalities of the eye and orbit. As high frequency sound waves (5 to 20 megahertz) are projected through soft tissues, echoes are produced at tissue interfaces. These echoes are displayed on oscilloscopes as either one-dimensional amplitude spikes (A-mode ultrasonography), or as dots integrated into a two-dimensional image representing a thin section through the entire orbit (B-scan ultrasonography). A-mode indicates tissue substance, while B-scan illustrates tissue morphology. With this technique, orbital tumors are clearly distinguished in terms of their location, size, and configuration, as well as the basic tissue type (cystic, solid, angiomatous or infiltrative). Other orbital processes are defined by ultrasonography also, including inflammatory conditions such as diffuse pseudotumor or cellulitis, congestive conditions such as dysthyroid exophthalmos, and orbital hemorrhage. Intracranial and vascular etiologies of exophthalmos have no specific ultrasound signs. In a series of 258 consecutive patients with unilateral exophthalmos examined with ultrasonography, diagnosis of tumor was made in 26 percent (66 cases). Overall accuracy of orbital tumor diagnosis by ultrasonography was 94 percent in this series. Tumor localization, configuration, and extent indicated by the test aided in selecting surgical approaches. Other patients in the series were diagnosed ultrasonically as a variety of other entities, mostly inflammatory and dysthyroid exophthalmos. Normal ultrasound studies were found in 19 percent. None of these patients had subsequent diagnosis of tumor. Diagnostic ultrasonography is capable of detecting orbital tumors and distinguishing them from inflammatory, congestive, and other causes of exophthalmos with a high degree of reliability. The test is painless, well tolerated, non-invasive, and non-toxic. It now has a prominent role in evaluation of any patient with exophthalmos.

Diagnostic ultrasound is a noninvasive, well tolerated, safe procedure with no toxicity which aids the ophthalmologist by demonstrating the integrity of the intraocular contents or the presence of tumors, retinal detachments, vitreous membranes or hemorrhage, foreign bodies or other structural changes in eyes with opaque media which cannot be adequately evaluated optically. Orbital mass lesions and inflammatory changes can be demonstrated and ultrasonic evaluation should be utilized early in the diagnostic evaluation of exophthalmus in combination with other radiographic techniques. The ultrasound examination does require a certain technical skill and experience in interpretation as well as judgment in order for it to be a reliable diagnostic test.

After a short description of ultrasound A- and B-scan-techniques, the ultrasonic findings in the different diseases of the eye and orbit are discussed. The results, as presented in this paper, show that ultrasound proves to be a useful aid in the evaluation and differential diagnosis of ocular pathology.

The author proceeds on the assumption that the majority of ocular diseases can be diagnosed by the primary care physician. The interpretation of common symptoms and guidelines for examination of the eye are provided.

The use of B-can ultrasonography in ophthalmology is becoming increasingly important. There are several advantages of the Bronson-Turner system when compared with other B-scan instruments. The unit is quite compact and much less expensive. There is no need for a special laboratory and trained personnel, since it is operated easily by the ophthalmologist. Because a water bath is not necessary, uncooperative patients and children can be evluated. This instrument has been proven reliable and accurate in the diagnosis of retinal detachment, choroidal tumors, and intraocular foreign bodies, and is also capable of revealing more subtle abnormalities such as retinoschisis and vitreous membranes. The Bronson-Turner ultrasonoscope provides the clinician with a valuable instrument to evaluate ocular abnormalities in the presence of opaque media.

Ultrasonography (echography) is a valuable diagnostic modality in ophthalmology. Its use in the detection and differentiation of intraocular and orbital diseases is expanding. B-scan provides cross-sectional display of diseased tissues and is valuable in detecting unsuspected disease. Quantitative A-scan is capable of demonstrating the internal texture of lesions, and this capacity coupled with the physician's familiarity with the histologic appearance of certain intraocular lesions often can lead to an accurate tissue diagnosis or can identify a group of possible diagnoses.

The development and early clinical results of a real-time color B-scan ultrasonoscope are described. This instrument uses color to display detailed echo amplitude information more quantitatively than is possible with gray scale. With real time, dynamic changes are seen during the examination. Conversion of the amplitude information into binary coded decimal code permits separation into ten color steps and also eliminates "blooming" of the cathode ray tube, as seen in black and white. Integrated circuitry is used, providing a portable, relatively inexpensive unit. Early clinical work in ophthalmology is illustrated.

After a short introduction about the ERG and EOG different indications for electrophysiological tests are pointed out. By means of ERG and EOG it is possible to distinguish diffuse tapetoretinal degenerations from other ophthalmological, very similar retinal diseases. With the help of the electrophysiological tests one can find the place of damage of the very same retinal disease. Only in combination with other examination methods one can confirm a diagnosis by means of the electrophysiology.